Abstract: PUB399
Does the Incidence of Dementia Increase After General Anesthesia in Patients with CKD? A Nationwide Population-Based Cohort Study
Session Information
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Yoo, Kyung Don, Ulsan University Hospital, Ulsan, Seoul, Korea (the Republic of)
- Park, Kyung sun, Ulsan University Hospital, Ulsan, Seoul, Korea (the Republic of)
- Park, Jongha, Ulsan University Hospital, Ulsan, Seoul, Korea (the Republic of)
- Lee, Jong Soo, Ulsan University Hospital, Ulsan, Seoul, Korea (the Republic of)
- Kim, Clara Tammy, Hallym University, Gangwon-do, Korea (the Republic of)
Background
Patients with chronic kidney disease (CKD) were regarded as increasing the risk of cognitive dysfunction according to kidney function. However, little is known about the relation of intraoperative aspect for CKD patients with general anesthesia.
Methods
A population-based prospective cohort study was conducted using the Korean National Health Insurance Service-National Sample Cohort database over 50 yrs, including CKD from 2003 and 2013. The primary outcome was the incidence of dementia using Korean Classification of Diseases codes, and receipt of medication such as donepezil, rivastigmine, galantamine, and memantine. Time-varying Cox regression analysis was applied for risk analysis of dementia.
Results
The 84 of the 1,676 participants of general anesthesia groups had developed newly dementia after surgery (5.0%). Of the 3,821 control groups that had CKD but did not have general anesthesia, 283 participants had presented incident dementia (Figure 1).
In time-varying Cox regression analyses revealed that general anesthesia group did not increase the development of dementia in CKD patients, compare to control group (HR 1.053, 95% CI 0.819-1.353) after adjustment of age, sex, health security certification, history of depression, diabetes, hypertension, cerebrovascular disease, ischemic heart disease, quintile group for health care visit frequency and Charlson comorbidities score. Male sex, old age, history of depression and cerebrovascular disease were an independent risk factor of incident dementia in CKD patients, irrespective of anesthetic methods.
Conclusion
In CKD patients, general anesthesia operation did not increase the risk of incident dementia. Subgroup analysis was warranted, especially in patients with advanced CKD, including dialysis.